---
title: "Voices & Participation of Stakeholders in Health Service Delivery"
date: '25 August - 23 October 2022'
output: 
  flexdashboard::flex_dashboard:
      source_code: embed
      social: menu
      
---
```{css}
body > div.navbar.navbar-inverse.navbar-fixed-top > div > div.navbar-header > span.navbar-brand {
    font-size: 25px;
    color: white;
}
```

```{r setup, include=FALSE}
library(flexdashboard)
library(knitr)
```


## Column 1 {data-width=650, .tabset}

### Overview


About this course 


The short course titled **Voice & Participation of Stakeholder in Health Service Delivery** is designed for public health professionals in Bangladesh. The course has been developed by the Centre for Professional Skills Development in Public Health (CPSD) at [BRAC James P Grant School of Public Health (BRAC JPGSPH)](https://bracjpgsph.org/), BRAC University in collaboration with [Bangladesh Health Watch (BHW)](https://bangladeshhealthwatch.org/). The course focuses on two major concepts: voice and participation. Voice is defined as the ability of citizens to express their preferences and take part in decision making. Community Group (CG) at Community Clinic (CC) - lowest tier public health facility in Bangladesh – is an example of voice. The critical point is sometimes the voice of marginalized groups is not heard by the responsible authorities while participation in decision making leads to better health outcomes and reduces inequality in health outcomes and access to services. Community participation is defined as people in a community are involved in projects or programs to solve their own problems using local resources. Community Participation encourages the use of local knowledge and resources leading to promote a more sustainable approach to development. Community health workers (CHWs) programs are one of several avenues of community participation. 



Who is this course for

This course is for: health programme planners and managers of Government, 
NGO/INGO and private sector, University faculty (particularly public health), 
other professionals in the health sector, and journalists.


Outline of the course

This course is divided into four themes as follows: 

Theme-1:  Introduction to Voice and Community Participation, Stakeholders in Health Service Delivery. Introductory session laid the foundation for the short course, ensuring participants are equipped with knowledge of basic concepts of voice, participation and primary health care (PHC) in the first two sessions of Day-1 along with giving concrete examples of voice and participation in the context of Bangladesh. We have bear in mind that primary health care systems are built around community health workers (CHWs) and Community Clinic (CC) – a lowest level public health facility in the country. After laying the foundation in introductory sessions, Day-2 focused on connecting communities to the health systems via community health workers. It  emphasized that community participation is an essential part of promoting health services. Community health workers (CHWs), working at government and non-government health systems, could play a critical role for ensuring PHC services leading to achieving Health for All (HFA) in Bangladesh.

Theme-2: Approaches and Challenges to Voice and Community Participation: Role of power, political economy in Implementing Primary Health Care (PHC). It explored different approaches and associated challenges to voice and participation in implementing and scaling PHC services in Bangladesh along with setting some examples. Against this backdrop, Day-3 introduced the role of Local Government Institutions (LGIs) in (health) service delivery as well as explore practical challenges in effective community participation for health service delivery in the country. Day-4 provided a glimpse of the GO-NGO partnership for effective primary health care service delivery along with giving some solid examples that have addressed key challenges in the country drawing examples from BRAC health programs. 

Then, Theme-3:  Strategies for Voice and Community Participation in Health Service Delivery. It demonstrated different strategies of community participation undertaken in real world situations.  It focused on how community members are in the best position to provide care to their neighbours. More specifically, the first session of Day-5 discussed how government initiatives at the local level via community participation become a model for the country. Similarly, second session of Day-5 showed civil society initiatives (including NGOs) for addressing humanitarian crises via local resource mobilization/community participation with a solid example from Gonoshasthaya Kendra (People’s Health Center) and Sajida Foundation. Day-6 was a panel discussion session with experts in respective fields who would share their perspectives on the panel discussion topic: Strategic interventions for promoting Voice & Participation in Health Service Delivery in Bangladesh: Challenges and Opportunities.

Finally, Theme 4: The Service Delivery Improvement Project (SDIP): A Practical Tool for Community-based Project Planning and Management. Under the final theme of the course, Day-7 to Day-12 focused on useful practical tools (e.g., SWOT Analysis, PESTEL Analysis, Stakeholder Analysis, Problem Tree Analysis, Objective Tree Analysis, Risk Analysis, Vertical and Horizontal Logic of Log Frame) for designing a project related to address/improve health problems of community people. It guides participants to explore root causes of health problems through problem tree and stakeholder analysis focusing on community level health issues and finding an innovative solution to solve those problems. It focuses on useful practical tools for designing a project related to address/improve health problems of community people. It guides participants to explore root causes of health problems through problem tree and stakeholder analysis focusing on community level health issues and finding an innovative solution to solve those problems.







Course skills learning outcomes  

By the end of this course, participants would be able to:
 
  - Understand basic concepts of voice and participation, and primary health care (PHC) leading to improved health service delivery to community people.
  
  - Describe the unique value of voice and participation to the health systems to ensure primary health care in the country. 
  
  - Illustrate the value that community health workers bring to communities; the way in which community health workers strengthen health systems in Bangladesh.
  
  - Understand the role of local government institutions (LGIs) in health service delivery through effective community participation. 
  
  - Understand the structure and management of the lowest level public health facility (e.g., community clinic) in Bangladesh.
  
  - Understand strategic GO-NGO partnership towards addressing challenges in delivering primary health care in Bangladesh. 
  
  - Develop a solution project focusing on addressing health problems that can be solved at community level through community participation applying Service Delivery Improvement Project (SDIP) tools. 


### Course Implementation

Course Structure


This **ONLINE** course was implemented in three phases: 

Phase-1: Core course (teaching-learning module) was conducted between 25 August – 22 September 2022, three days a week (Mondays, Wednesdays, Thursdays), from 2:30PM to 4:30PM each day. Additionally, BRAC JPGSPH kept daily attendance through a Google attendance sheet. Service Delivery Improvement Project (SDIP) is usually formed on orientation day based on participants' preferences and institutional preferences.

Teaching and Learning (T&L) methodologies of the course involved video-led interactive discussions, case studies, group exercises followed by group presentation, brainstorming and discussion, and panel discussions with experts in the field. Participants are supposed to spend about 1-2 hour a week on self-directed reading.

Phase-2: Structured follow-up sessions was started right after completion of Phase-1 which was continued between  26 September and 20 October 2022 (once a week for each team). Each Service Delivery Improvement Project (SDIP) Team met virtually with the JPGSPH Team once a week using Zoom to discuss their problem and challenges in developing their SDIP Plan and showed their progress with the project. It should be noted that this follow up is critical to reinforce their learning as they intend to apply their learning through a practical solution project. We used to meet one a week with each of thee teams (Monday, Wednesday, Thursday). During this follow up, the Lead Facilitator provided feedback on their final draft SDIP and each team was supposed to address those feedback and resubmit the updated SDIP for further comments. Thus, each team completed SDIP through iterative process which is unique feature of this experiential learning course. 

Phase-3: Each SDIP Team is supposed to submit the final SDIP Report after incorporating comments and feedback to successfully complete the short course. As such, each team did their final Submission on 23 October 2022; 5PM. Only successful participants will be awarded Course Completion Certificate from BRAC James P Grant School of Public Health (BRAC JPGSPH), BRAC University on 3 December 2022, Saturday (TBC). 

 

Course evaluation

We followed a Daily Evaluation strategy instead of end of the course evaluation approach. We sent a Google Form to each participant after each session and requested them to return the form before next session. Participants evaluated three aspects of the course: learning content, teaching and learning (T&L) methods used, and facilitation. There were open ended question in the form to receive participants' feedback on the course. Participants feedback helped us to improve the short course.

### Course Resource Persons 



Resource persons 
 
(*Alphabetical order of last name*) 
 
Dr. Yasmin H. Ahmed
 
Advisor
 
Bangladesh Health Watch (BHW)
 
Dr. Manzur Kadir Ahmed
 
Chief Executive Officer (CEO)
 
Gonoshasthaya Kendra, Savar, Bangladesh 
 
Ms Shashwatee Biplob
 
Programme Head 
 
Social Empowerment and Legal Protection (SELP) Programme, BRAC Bangladesh
 
Dr Abu Jamil Faisel 

Public Health Specialist
 
and BHW Working Group Member
 
Mr Md Fazlul Hoque
 
Deputy Executive Director
 
Sajida Foundation, Dhaka, Bangladesh
 
Dr. Mohammad Mushtuq Husain
 
Advisor to IEDCR
 
Ministry of Health and Family Welfare (MoHFW)
 
Government of Bangladesh (GoB)
 
Dr. Akramul Islam
 
Senior Director

Communicable Disease (TB & Malaria) & WASH, BRAC Bangladesh, Dhaka 
 
Dr. Mohammad Zahirul Islam
 
Senior Programme Officer/ Health Avisor
 
Development Cooperation Section, Embassy of Sweden, Dhaka

Dr Rizwan Khair
 
Associate Professor
 
South Asian Institute of Policy and Governance (SIPG), North South University, Dhaka 


Dr. Badiul Alam Majumdar
 
Vice President & Country Director
 
The Hunger Project Bangladesh, Dhaka  

Mr. Md. Helal Uddin
 
Former Additional Secretary (Planning)
 
Health Service Division, Ministry of Health and Family Welfare (MoHFW), Government of Bangladesh (GoB)
 


Course team

Dr Sabina Faiz Rashid

Dean and Professor

BRAC James P Grant School of Public Health (JPGSPH), BRAC University, Mohakhali, Dhaka



Dr Rizwan Khair
 
Technical Advisor
 
BRAC James P Grant School of Public Health (JPGSPH), BRAC University, Mohakhali, Dhaka


Dr Ataur Rahman

Advisor, Research Policy and Training

BRAC James P Grant School of Public Health, BRAC University, Mohakhali, Dhaka



Mr. Kazi Hasan Imam

Lead Facilitator

BRAC James P Grant School of Public Health (BRAC JPGSPH)

BRAC University, Mohakhali, Dhaka

Dr. Proloy Barua
 
Assistant Scientist

BRAC James P Grant School of Public Health (BRAC JPGSPH)

BRAC University, Mohakhali, Dhaka


 Mr. Munirul Islam
 
Senior Project Officer

BRAC James P Grant School of Public Health (BRAC JPGSPH)

BRAC University, Mohakhali, Dhaka



### Course Participants 
 
Course participants

```{r echo=FALSE, eval=TRUE, message=FALSE, warning=FALSE}
library("reactable")
library("htmlwidgets")
library("htmltools")
library("data.table")
voice_trainees <- data.table::fread("F:/R practice/Participants_data_voice_participation.csv")
reactable::reactable(voice_trainees,highlight = TRUE,
                            outlined = TRUE,
                            bordered = TRUE,
                            borderless = FALSE,
                            striped = TRUE,
                            compact = TRUE,
                            searchable = TRUE,
                            wrap = TRUE,
                     showPageSizeOptions = TRUE,
                     defaultPageSize = 50)
                     
                            
``` 



### Course Gallery 

Orientation Day

```{r, echo = FALSE, out.width="100%"}
myimages<-list.files("F:/BHW Dcuments/Main courses/Voice and participation/Final Draft Voice & Participation/DAYs/Orientation/", pattern = ".png", full.names = TRUE)
include_graphics(myimages)
```


Panel Discussion

```{r, echo = FALSE, out.width="100%"}
myimages<-list.files("F:/BHW Dcuments/Main courses/Voice and participation/Final Draft Voice & Participation/DAYs/DAY-6/", pattern = ".png", full.names = TRUE)
include_graphics(myimages)
```